| Purpose: By analyzing the dynamic changes of total bilirubin(TBIL),ratio of monocytes to lymphocytes(MLR),ratio of neutrophils to lymphocytes(NLR)and ratio of platelets to lymphocytes(PLR)in blood of patients undergoing craniocerebral tumor surgery in the First Affiliated Hospital of China Medical University from November 1,2020 to October 31,2022,To explore the diagnostic value of each index for intracranial infection after craniocerebral tumor operation.Method:Clinical data of 101 patients with craniocerebral tumors who received surgical treatment in the First Affiliated Hospital of China Medical University from November 1,2020 to October 31,2022 were collected and divided into two groups: In the non-intracranial infection group(group A)and intracranial infection group(group B),the number of cases in each group was as follows: 64 cases in the non-intracranial infection group and 37 cases in the intracranial infection group.The pathological types were as follows: 32 cases of meningioma,13 cases of pituitary tumor,22 cases of glioma,21 cases of schwannoma and 13 cases of others.Blood samples were collected before surgery and at the 1st,3rd,and 7th day after surgery,routine and biochemical examinations were performed,and NLR,PLR,and MLR were calculated.These data were processed by statistical software,and general clinical data were analyzed.Chi-square test was used for counting data,and T-test and Mann-Whitney U test were used for measurement data.The Receiver operating characteristic curve(ROC)was drawn for measurement data,and the Yoden index was calculated to find the optimal threshold of ROC curve,which was divided into binary variables for statistics,and then verified by chi-square test.Graphpad prism 6 was used to analyze and process the data,and P < 0.05 was statistically significant.Results: 1.On the first day after surgery,NLR,PLR,MLR and TBIL in the intracranial infection group were higher than those in the non-intracranial infection group,with statistical significance(P<0.05):The receiver operating characteristic curve analysis of NLR,PLR,MLR and TBIL showed that the area under ROC curve of NLR was 0.748,the cut-off value was 18.36,the sensitivity was 62%,and the specificity was 78%.Thearea under ROC curve of MLR was 0.661,the cut-off value was 0.51,the sensitivity was81%,and the specificity was 45%.The area under ROC curve of PLR was 0.711,the cut-off value was 267.26,the sensitivity was 65%,and the specificity was 72%.The area under ROC curve of TBIL was 0.636,the cut-off value was 9.5μmol/L,the sensitivity was 78%,and the specificity was 55%.2.The above results indicate that the four indexes may have auxiliary diagnostic value for intracranial infection after brain tumor surgery.Therefore,the combined analysis of the four indexes shows that the sensitivity of NLR+TBIL can be increased to 90%,but the specificity decreases to 60%,and the area under the ROC curve is 0.782.The combined sensitivity and specificity of the four indexes were 81% and 66%,and the area under the ROC curve was 0.783.The sensitivity and specificity of NLR+PLR+MLR was 80%,but the sensitivity was reduced to 56%,and the area under ROC curve was 0.762.The sensitivity and specificity of NLR+PLR+TBIL was 87%,64%,and the area under ROC curve was 0.780.3.Dynamic analysis of NLR,PLR,MLR and TBIL between intracranial infection group(group B)and non-intracranial infection group(group A)showed that:Preoperative NLR,PLR,MLR and TBIL of group A were lower than those of group B,but there was no statistical significance(P > 0.05).There were significant differences in NLR and PLR between the two groups on day 1,day 3 and day 7 after surgery(P<0.01),but no significant differences in MLR and TBIL between the two groups(P<0.05).The line chart showed that the trend of NLR,MLR and TBIL in the two groups was consistent,but the decrease of group B was significantly lower than group A.PLR trends of patients in the two groups were different.Patients in group A had an upward trend and then a downward trend,while patients in group B had an upward trend and no obvious improvement was observed after conventional treatment on the 3rd day after surgery.Conclusion: 1.NLR,PLR,MLR and TBIL all have auxiliary diagnostic value for intracranial infection after brain tumor surgery,and the combined analysis of NLR and TBIL has better ability to distinguish intracranial infection.2.PLR has better disease assessment ability than NLR,MLR and TBIL... |
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